Contacts

Thursday, October 9, 2014

Stigmatizing and Shunning the Severely Ill | Huffington Post

This article by Dr. Allen Frances hits
the nail on the head. People with severe mental illness/brain diseases, who
don't believe they are ill and lack capacity for informed consent, are allowed to live in the community delusional,
dysfunctional, and "YES" often dangerous to themselves and their family!Medical providers in our community
recently stated that perhaps my son would received "treatment in
jail" … since he has the right to refuse it in the community! Yet even in prison, he has rights to refuse the care he needs to restore his brain function! Only in Amercia are laws this insane! Thanks to
the laws that protect his civil rights … he had only received “3 weeks of medical
treatment in 2014” for a brain disease that has a 21-year documented history!

While NAMI and other national mental health groups focus
on bringing awareness that mental illnesses are treatable and spend millions on
anti-stigma campaigns … both they and society are turning a blind eye to what is really
going on behind the scenes due to the fight over funding. Consequently funds are being rerouted to the justice system,
jails and prisons. Dr. Frances’ article explains this with great detail.

"We are civilized people in the United States. We don't set up leper colonies or concentration camps or psychiatric snake pits to banish people with severe mental illness. Instead we send them to jail or prison -- almost 400,000 of them, more than 10 times the number receiving care in hospitals. And we also blithely ignore the fact that additional hundreds of thousands live homeless on the streets or in squalid housing and have little or no access to treatment.

The extreme absurdity of our system is perhaps best illustrated when some of our mentally ill are reduced to repeatedly inviting arrest in order to get "three hots and a cot." For them a restricted life behind bars beats a chaotic and dangerous life on the streets.

But for most prison is a living nightmare. People with mental illness don't adapt well to its rituals and dangers. They are vulnerable targets for physical abuse, rape, and prolonged (further crazy-making) solitary confinement. Our society's mismanagement of the severely mentally ill is a disgrace -- perhaps not quite as bad as medieval witch hunting, but close behind."

We can't in any way excuse it, but how do we explain the lousy care and subsequent shunning to prison and street? Some of the neglect certainly arises from felt economic necessity; many states have been forced to sharply slash spending to balance budgets, and one of the easiest things to cut is mental-health funding. But the fundamental reasons must go much deeper. The same states, simultaneously and without much notice or qualm, have radically increased their appropriations for prisons, despite the fact that it is much more expensive to cruelly imprison people with severe mental illness than to compassionately treat them in the community. It is penny-wise and pound-foolish to shortchange community treatment and housing while wasting funds on inappropriate prison beds.

The best explanation for this irrational distribution of scarce resources is the stigma of severe illness. We begrudge the severely ill the necessary funding for humane and cost-effective care but don't seem to mind locking them up in expensive and soul-destroying prisons.

Dictionary definitions of "stigma" describe it as a mark of disgrace, shame, dishonor, ignominy, opprobrium, humiliation, or bad reputation unfairly attached to a person, group or quality. Tellingly, the "the stigma of mental disorder" is almost always offered as the first and most classic example.

A troubling paradox has, I think, developed in the stigma
attached to mental illness: Never has there been less stigma for having mild
psychiatric problems, but never has there been more stigma for having severe
ones.

This has come about because the definition of "mental illness"
is now so loose: One in four of us qualifies every year, one in two across a
lifetime, and one in five is taking a psychiatric medicine.

There is enormous
power in these numbers.

The sting of having a psychiatric diagnosis or receiving
treatment is much reduced when so many people take psychiatric medication or
participate in psychotherapy."